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Prurigo pigmentosa: the “keto rash”

Blake P Mumford and Anita Lasocki
Med J Aust 2021; 215 (3): . || doi: 10.5694/mja2.51162
Published online: 2 August 2021

A 29‐year‐old Korean woman presented with a pruritic, reticulate, red‐brown, papular eruption overlying her clavicle and neck, occurring in the setting of carbohydrate restriction (Figure, A and B). Medical history included polycystic ovarian syndrome, impaired fasting glucose, and anorexia nervosa (in remission). Biopsy revealed non‐specific changes and a clinical diagnosis of prurigo pigmentosa was made. Rapid resolution occurred with minocycline and re‐introduction of complex carbohydrates.


  • 1 Skin Health Institute, Melbourne, VIC
  • 2 St Vincent’s Hospital, Melbourne, VIC



Competing interests:

No relevant disclosures.

  • 1. Michaels JD, Hoss E, Dicaudo DJ, Price H. Prurigo pigmentosa after a strict ketogenic diet. Pediatr Dermatol 2015; 32: 248–251.
  • 2. Beutler BD, Cohen PR, Lee RA. Prurigo pigmentosa: literature review. Am J Clin Dermatol 2015; 16: 533–543.

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